Maisto Stephen A, Simons Jeffrey S, Palfai Tibor P, Moskal Dezarie, Luehring-Jones Peter
Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244, USA.
Department of Psychology, University of South Dakota, Vermillion, SD, USA.
Arch Sex Behav. 2021 Oct;50(7):2843-2860. doi: 10.1007/s10508-020-01852-2. Epub 2021 Feb 16.
The purpose of this study was to examine the effects of alcohol intoxication and its interaction with contextual or situation (partner familiarity) and individual differences variables (effortful control, urgency, and whether taking pre-exposure prophylaxis (PrEP) medication) on sexual behaviors in men who have sex with men (MSM), a subgroup for whom HIV continues to be a major public health problem in the U.S. The participants were 236 men recruited from two northeastern U.S. cities and aged 21-50 years, M = 27.8). These men participated in a 6-week (two 3-week sampling bursts) experience sampling method (ESM) study. The ESM data were collected via use of software installed on the participant's own or study-provided mobile phone. Individual differences variables were measured by participants' completing questionnaires measuring effortful control and urgency, and the participant's self-report of whether he was currently taking PrEP. The ESM data pertained to sexual behavior as well as situation variables of familiarity of relevant sexual partners and number of standard alcohol drinks consumed. The results generally were consistent with hypotheses, as alcohol intoxication showed a curvilinear relation to the occurrence of condomless anal intercourse. Furthermore, the likelihood of occurrence of condomless anal sex increased with increased familiarity of the sexual partner. Similarly, taking PrEP increased the likelihood of occurrence of condomless anal sex. At the same time, alcohol's effects were moderated by all three individual differences variables as expected, but the prediction that partner familiarity would moderate alcohol's effects on the occurrence of condomless sex was not supported. Clinical implications of the findings center on the application of the data to HIV prevention programs toward inclusion of more empirically supported, nuanced information on the relation between acute alcohol intoxication and sexual behavior. Directions for further research address the need for additional testing and refinement of a person × situation approach to alcohol and sexual behavior. Furthermore, it is argued that it is important to refine further the concept of sexual risk in the context of taking PrEP and to conduct more detailed, multivariate studies of the relation between taking PrEP and patterns of sexual behavior.
本研究的目的是考察酒精中毒及其与情境或状况（性伴侣熟悉程度）以及个体差异变量（努力控制、冲动性，以及是否服用暴露前预防药物（PrEP））之间的相互作用，对男男性行为者（MSM）性行为的影响。在美国，该亚组人群中，艾滋病毒仍然是一个主要的公共卫生问题。参与者是从美国东北部两个城市招募的236名年龄在21至50岁之间的男性（M = 27.8）。这些男性参与了一项为期6周（两个3周抽样周期）的经验取样法（ESM）研究。ESM数据通过安装在参与者自己或研究提供的手机上的软件收集。个体差异变量通过参与者填写测量努力控制和冲动性的问卷以及参与者关于自己当前是否正在服用PrEP的自我报告来测量。ESM数据涉及性行为以及相关性伴侣的熟悉程度和饮用标准酒精饮料数量等情境变量。结果总体上与假设一致，因为酒精中毒与无保护肛交的发生呈曲线关系。此外，随着性伴侣熟悉程度的增加，无保护肛交发生的可能性增加。同样，服用PrEP增加了无保护肛交发生的可能性。同时，正如预期的那样，酒精的影响受到所有三个个体差异变量的调节，但性伴侣熟悉程度会调节酒精对无保护性行为发生影响的预测未得到支持。研究结果的临床意义集中在将数据应用于艾滋病毒预防项目，以纳入更多关于急性酒精中毒与性行为之间关系的经实证支持的、细致入微的信息。进一步研究的方向涉及对酒精与性行为的人×情境方法进行额外测试和完善的必要性。此外，有人认为，在服用PrEP的背景下进一步完善性风险的概念，并对服用PrEP与性行为模式之间的关系进行更详细的多变量研究很重要。
